The Hip

Achilles Tendon Rupture

(see also: Achilles Tendonitis) Discussion ruptures typically occur after age 30, more often in people beyond middle age; rupture at musculous tendinous junction occurs most often in young people, but ruptures near the calcaneus also occur; inciting event may be related to atrophy of the soleus muscle, and commonly occur in weekend athletes; in 5-33% … Read more

ACID PHOSPHATASE

Radioimmunoassay (RIA) determination usually specific for prostate; not a screening test; Increased: Carcinoma of the prostate (usually metastatic), prostatic surgery or trauma; Rarely increased w/ infiltrative bone dz (Gaucher’s dz, myeloid leukemia), prostatitis, or benign prostatic hypertrophy;

Adult Humeral Inter-condylar Fractures: Plate Application

– Technique Considerations: – following restoration of fracture anatomy, contour 1/3 tubular, 3.5 pelvic reconstruction, or 3.5 DCPs, to fit medial and lateral aspect of distal humerus; – the strongest bone lies along medial and lateral columns and therefore the plate screws should be placed here rather than central portion of distal end of the … Read more

Fractures of the Acetabulum

(see also: Pelvic Frx; Radiographs; Work Up and Treatment) Anterior Column Frx Anterior Wall Fractures Both Column Frx Central Acebular Fracture Dislocations Classification and Column Theory Displaced Dome Fractures Heterotopic Ossification Hip Frx Fracture Dislocations of the Hip Judet View Iliofemoral Approach to the Acetabulum Ilioinguinal Approach to the Acetabulum Pediatric Acetabular Fractures Posterolateral Approach: … Read more

AC Joint Separation

Discussion tears of AC & CC ligaments (from fall on tip of shoulder) allows upper limb to drop away from clavicle, producing separation of AC joint; diff dx distal clavicular physeal separation childhood equivolent of AC separation; atraumatic AC joint laxity (from ligamentous laxity) Classification Rockwood Classification type I sprain of joint with out a … Read more

AC Joint Arthrosis / Open Distal Clavicle Excision

Discussion general discussion: clinical and radiographic findings Surgical Technique Subacromial Decrompression Arthroscopic Distal Clavicle Excision: Open Clavicle Excision: Surgical Technique: Modified Weaver Dunn Procedure: Complications lateral elevation of the clavicle: lateral elevation is often associated w/ pain; ref: Sequential Resection of the Distal Clavicle and Its Effects on Horizontal Acromioclavicular Joint Translation references: Complications after … Read more

Absent Thumb

Discussion total absence of the thumb may be an isolated anomaly, but it is often associated with some other congenital malformation; absent thumb may be inherited as autosomal dominant or may be sporadic; absent thumb is frequently observed in Holt-Oram syndrome, Fanconi’s anemia, and ring D chromosome abnormalities; absent radius is almost always associated with … Read more

Above the Knee Amputation

  (see also: AKA Prosthesis, Amputations in the Diabetic Patient Discussion average AK amputee walks 43% slower and expends 89% more kcal/min than the normal person; if proximal circulation is adequate, a longer anterior muscle flap may be left and the combination myodesis- myoplasty technique is used; ability to ambulate with a prosthesis depends heavily … Read more

Healing of Cartilage

(see also: Chondral Injuries: Nourishment) Discussion articular cartilage is avascular & is prevented from mounting a vascular response when there is isolated cartilage injury; absence of vessels w/ in cartilage imposes limitations on healing potential; indeed, some traumatic defects in cartilage apparently never heal; chondrocytes in articular cartilage are capable of cell division & are … Read more

Pseudogout and Chondrocalcinosis

Discussion acute arthritis caused by CPPD crystal-induced inflammation; almost as common as gout & may perfectly mimic gout during acute flare; pseudogout attacks occurring before age 50 are uncommon; see: pseudogout occurence after joint replacement references: A histological study of calcium pyrophosphate dihydrate crystal-deposition disease. Clinical features of pseudogout attack. A survey of 50 cases. … Read more